peripheral vascular

Question 1

what is the ABPI

Answer 1

leg BP : arm BP

Question 2

what ABPI would indicate calcification

Answer 2

> 1,2

Question 3

what ABPI is normal

Answer 3

1-1.2

Question 4

what ABPI indicated PAD

Answer 4

<0.9

Question 5

how does intermittent claudication present

Answer 5

aching/ burning walking which is relieved by rest

Question 6

1st line invx intermittent claudication

Answer 6

USS

Question 7

what invx required before intervention in intermittent claudication

Answer 7

MRA

Question 8

what ABPI indicated critical limb ischaemia

Answer 8

<0.5 (severe disease)

Question 9

symptoms critical limb ischaemia

Answer 9

1 of: rest pain for 2+ weeks // ulcers // gangrene

Question 10

features of acute limb-threatening ischaemia

Answer 10

pale, pulseness, pallor, pain, paraesthesia, cold

Question 11

1st line invx acute limb threatening ischaemia

Answer 11

USS doppler

Question 12

difference in history between thrombus and emboli acute critical limb ischaemia

Answer 12

thrombus - plaque rupture (pre-existing PAD) // emboli eg A fi =b

Question 13

initial mx acute critical limb ischaemia

Answer 13

ABCDE // IV opioids // IV heparin

Question 14

definitive mx acute critical limb ischaemia

Answer 14

thrombolysis // embolectomy // angioplasty // bypass // amuptation

Question 15

lifestyle mx for PAD

Answer 15

lose weight + stop smoking + exercose

Question 16

1st line mx PAD

Answer 16

clopidogrel (+ statin)

Question 17

when are endovascular revascularization procedures done for PAD

Answer 17

short segment stenosis (<10cm) or aortic iliac disease in high risk patients

Question 18

when are surgical revascularization procedures done for PAD

Answer 18

long segments, multifocal segments, common femoral and infrapopliteal

Question 19

how do most venous leg ulcers form

Answer 19

due to venous insufficiency

Question 20

features of venous insufficiency

Answer 20

oedema, brown pigmentation, lipodermatosclerosis, eczema

Question 21

where do venous ulcers form

Answer 21

usually above the ankle + painless

Question 22

invx venous ulcer

Answer 22

USS

Question 23

mx venous ulcer

Answer 23

4 layer compression bandage (if no PAD)

Question 24

what can be done for non-healing venous ulcers

Answer 24

skin graft

Question 25

where do arterial ulcers form

Answer 25

toes and heels

Question 26

presentation arterial ulcer

Answer 26

painful, cold, may be gangrene

Question 27

where do neuropathic (diabetic) ulcers form

Answer 27

plantar surface of metatarsal head or hallux (base of toes)

Question 28

what vein do varicose veins usually form

Answer 28

great and small saphenous vein

Question 29

RF varicose veins

Answer 29

age, female, pregnant, obesity

Question 30

invx varicose veins

Answer 30

USS doppler (retrograde)

Question 31

conservative mx varicose veins

Answer 31

leg elevation, weight loss, exercise, compression stockings

Question 32

reasons for referral varicose veins

Answer 32

pain, swelling // bleeding // skin changes from venous insufficiency // superficial thrombophlebitis // leg ulcer

Question 33

mx varicose veins (3)

Answer 33

endothermal ablation // foam sclerotherapy // surgical ligation

Question 34

what is superficial thrombophlebitis + where does it usually occur

Answer 34

thrombosis of a superficial vein - saphenous

Question 35

acute cause of superficial thrombophelbitis

Answer 35

DVT

Question 36

mx superficial thrombophlebitis

Answer 36

oral NSAIDS + compression stockings +/- topical NSAIDS or heparinoids

Question 37

what invx should all patients with superficial thrombophlebitis recieve

Answer 37

USS

Question 38

what is reynauds

Answer 38

hands become white and blue in cold - affects females

Question 39

mx reynauds

Answer 39

CCB

Question 40

where are emboli in the upper limb likely to lodge

Answer 40

50% brachial, 30% axillary

Question 41

what is buergers disease

Answer 41

small and medium vessel vaculitis assoc with smoking –> claudication, superficial thrombophlebitis + reynauds